very necessary, of course, but they seem to be more like social services than fundamental research concerned with the aged.

Now about the structural form. I firmly believe that support for studies of the aged and aging should come under one National Institute of Health. For people "in the field" that would be the simplest form. If each Institute of health had its own section on aging the confusion "in the field" would be great, "redtape" would increase and correspondence would be slowed down.-Chester Alexander.

I am not at all convinced that there should be a National Institute of gerontology because of the fact that the problems of aging cut across all the problems of the existing Institutes of Health and that difficulties would arise if a separate Institute were established. If each of the existing Institutes has an aging section, there could be established a coordinating center to tie the work of the separate Institutes together in some fashion and provide for some interchange and communication between the separate Institutes. There is perhaps more to be said for an Institute dealing with the psychological, social, and economic aspects of aging than for one dealing with the medical and biological aspects of aging. I feel that the question of the central organization to stimulate research in this area deserves much discussion.

I would point to the fact that research allotments by Government departments seems to be mainly on a contract basis with close supervision and with problems set by the departments; whereas research allotments by the National Institutes and by the National Science Foundation are essentially grants-in-aid with problems set by the individual investigators or the agencies that apply, with freedom in the conduct of studies within broad limits. If we can secure a considerable group of competent, well-trained and bright research workers interested in aging and can make money and facilities available without too many constraints, the field will not only move forward with rapidity but will accelerate. It is an area that needs venturesome thinking as well as good research designs.-John E. Anderson.

It is my firm conviction that we should have a National Institute of Gerontology. I think that only in this way can the efforts of many investigators in the field of research on aging find a common focus. I believe that the mere establishment of such a National Institute would lead to a tremendous upsurge of interest in studies on aging. I believe also, that within a few years certain key channels of research would emerge, largely through the establishment of such an Institute. The office of the Center for Aging Research has done excellent work in the past few years but it cannot in any sense fill the need for a National Institute of Gerontology in which intramural work on the aging process would be carried out and to which laboratories in many parts of the country and in many countries abroad would look for inspiration, information, and possible assistance.

I believe that the National Institute of Gerontology should be primarily a center for biological and medical research in the field of aging.—Warren Andrew.

I do not believe that there is a need for a National Institute of Gerontology. Once again aging is a problem in general biology, genetics, cardiology, etc., and is not a field in itself, but one that needs correlation both at the administrative and research levels.—Henry H. Banks.

Your question No. 10 interests me very much as I have often wondered whether there should not be a National Institute of Gerontology. I am no expert on organization but feel strongly that an interdisciplinary approach is desirable i.e., some mechanics by which experts in one area may have conferences with experts in other areas from the planning stage on. Perhaps the Federal Government should provide funds and consultation services for research done in many research centers and by lone individuals.

It is hoped that the White House Conference on Aging will not only highlight problems but will give insight and inspiration on research to scientists in all fields concerned with the happiness [and well-being of aging citizens.-Belle Boone Beard.

The addition of a National Institute of Gerontology would not offer any advantage. At best, gerontological research should be a subdivision of the current Institutes. It is not germane which Institute supports a particular program as long as there is support available for worthwhile projects.-Howard B. Bensusan.

I believe a National_Institute of Gerontology would be a good idea in due course but not now. There are relatively few gerontologists and a National Institute would drain all the workers away from existing institutions. I believe a start should be made with faculty appointments in gerontology in various universities and then as younger workers realize there is a future in this field and begin to take it up and so multiply their numbers, then is the time for stage 2 which would be the inauguration of a National Institute of Gerontology.Geoffrey H. Bourne.

What is imperatively needed to achieve a breakthrough is the establishment of a new Institute which has as its sole objective the promotion of significant gerontological research. This new organization should be a National Institute of Gerontology of equal status with the existing Public Health Institutes. It should be supported by funds granted by Congress. Its mandate should be to cover adequately all the aspects of gerontology: biological, economic, educational, political, psychological, and sociological. Its operation should include the planning of a program of projects that will significantly advance both basic and applied research.

The time is ripe for organizing a breakthrough to establish an integrated program of research through a National Institute of Gerontology with facilities and funds commensurate with the magnitude and complexity of the problems now confronting our aging population.-Ernest W. Burgess.

This is a very complicated series of questions, which cannot be answered without a complete understanding of the administrative structure of the National Institutes of Health. I do not feel that I have sufficient knowledge to offer definite and detailed answers as to how to carry out my proposal.

The Center for Aging Research of the National Institutes of Health has done a remarkable job in stimulating interest in aging research and developing research support for such work. However, since the health problems of the aged are of utmost importance to our society, it appears that an even more effective job could be done by recognizing this and creating an Institute of Gerontology within the existing Institutes of Health.

Since gerontology is a rather poorly defined area of study, an Institute of Gerontology would include social science research and would overlap with all the existing Institutes of Health. Mechanisms of liaison and cooperation would have to be established, or all the Institutes would suffer. This important requirement of liaison and cooperation makes it mandatory that such an Institute be established within the existing framework of the National Institutes of Health.-Ewald W. Busse.

A Division of Gerontology in the existing Institutes of Health would seem to me to be in order. In this way, all the problems pertaining_to_gerontology will be better understood, brought together and directed.-Earl O. Butcher.

In answer to question No. 10, I do not feel that there should be a National Institute of Gerontology any more than there ought to be a national institute for high school seniors or college students; or national institute for widowed grandmothers. I think the problems of the aged are problems but every other group, every individual has problems and I think that trying to develop national institutes only furthers bureaucracy and enlarges the scope of Government interferences in our everyday lives.-R. J. Carabasi.

I believe there are good grounds for the establishment of a National Institute of Gerontology. However, I recognize that many leaders in the medical and biological areas of aging are likely to oppose such an Institute because they think it might result in the fragmentation and the transfer of research in the existing special Institutes to such a new Institute. I would be opposed to any breakup of the research of any of the existing medically oriented Institutes of Health. But there are vast gaps in the present aging research. It is my belief that a National Institute of Gerontology should be responsible for covering these gaps and fostering an effective interrelationship among the areas covered by the existing Institutes. As between setting up a special Bureau of Aging and a National Institute of Gerontology in the Department of HEW, I believe the latter is much more important and would be much more significant in the long run for the aged.-Wilbur J. Cohen.

At present, gerontology suffers more, in my opinion, than any of the other sciences in being a part-time occupation. My own case is typical. I have been concerned with gerontology for years, but I have earned my salary and my living by my work on cancer. Fortunately, there is a very close connection between aging and cancer. Public welfare demands that we strengthen the professions of gerontology and geriatrics.-E. V. Cowdry.

Recognizing the advantages and disadvantages of an Institute of Gerontology, I find this a difficult question to answer. Such an Institute would, of course, bring additional focus to aging and would perhaps better integrate the various types of gerontological research. On the other hand, I have become increasingly impressed with the fact that health problems are seldom age specific. Sickness has to be viewed in a wide age spectrum, not "65 years and over." Again, as we emphasize in the "Handbook"

This is demonstrated by the significance of medical care and health practice during childhood, young adulthood, and middle age. It is further illustrated in terms of a community's resources for health, its physicians, dentists, nurses, hospitals, clinics, rehabilitation centers-virtually all of which serve both young and old."-Eugene A. Confrey.

Again, my limited experience in the field makes me chary of making recommendations as to the particular administrative forms likely to be most effective. I am of the general impression that until there is more grassroots organization to support and protect it at budget time a National Institute would get starved and produce such limited results as to make it suspect. But this is an impression that surely needs more evidence for it than I can produce.--Fred Cottrell.

As to the question of the National Institute of Gerontology, I would like to suggest that a strong nucleus for such an Institute is already in existence. The Gerontological Branch of NIH, USPHS, has enjoyed a fine national and international reputation for many years under the able leadership of Dr. Nathan Shock. Further expansion of this Institute, as well as strengthening its clinical and research facilities, would be the logical answer to this question. To my knowledge, Dr. Shock has already developed detailed plans for such expansion. With the provision of the necessary funds, this enlarged institution could serve as the proposed National Institute of Gerontology. This solution would eliminate the complications which undoubtedly would arise if geriatrics and gerontological research were to be distributed among the existing Institutes. It is conceivable, however, that the proposed National Institute of Gerontology would not be able to handle all problems of the aging patient, and such special problems as mental disease should remain in the sphere of interest of the NIMH and other nongovernmental health research institutions.-Michael M. Dacso.

There seems to be no question but that aging needs to be represented at the national level by some unit which would insure development of a well-rounded approach to all aspects of the problem. I would not, however, favor the estab

lishment of a National Institute of Gerontology as one of the Institutes under the National Institutes of Health, because the social sciences would necessarily be submerged in the general orientation of the Institutes toward health, medical, and biological studies. I would, therefore, urge again that a special unit on aging be made a part of the National Science Foundation. This unit would deal with studies in the fields of social science and social welfare, the National Institutes of Health would continue its present programs on aging, and combined committees could serve multidisciplinary project requests involving both the health sciences and the social sciences.-Wilma Donahue.

Viewed as a metabolic disease, aging would appear to warrant the status accorded to other diseases associated with it. On the other hand, gerontology may be regarded as a purely fundamental science, to be included in the same category with the study of growth, reproduction, or other basic biological processes. Even as such, however, it does not appear to belong in one of the existing Institutes. A new Institute is therefore indicated, either in gerontology or in basic research.-H. H. Draper.

I would favor a National Institute of Gerontology; in fact, have such an unsubmitted proposal to my nearby university (Cornell) somewhere in my files.—Dr. G. L. Freeman.

NIH

On item c I have urged, both a NIH and at the VA, that the closest liaison between these groups should be established for research in aging. The VA has an unparalled research population, the opportunity to conduct vast cooperative clinical experiments, an unusually strong group of research psychologists, a sympathetic administration and well-considered approach, and like assets. has the great mass of scientific investigators and resources, at least two groups that have long done extensive work specifically in the field of aging, and other important assets. Whether, to turn to your question No. 10, there should be a National Institute of Gerontology, is obviously germane to this point. There is the universal problem of integrating on the one hand and, necessarily, dividing on the other. Since the VA as well as NIH-and probably other agencies-have such major and legitimate interests in the problem of aging, I should be inclined to look toward some interagency organization rather then simply another Institute in the National Institutes of Health. Perhaps some integrative committee or agency, leaving the actual research organs scattered about as they are, would be a useful approach.-R. W. Gerard.

It is my opinion that there should be a National Institute of Gerontology, which should come under the existing Institutes of Health. Such an Institute would be of service in supervising current research in the field of aging and in preparing the findings of such research for practical application. Such centralization should tend to prevent duplication of work and/or sidetracking of potentially important research results. Social welfare research could be included in the activities of this Institute.-Leontine Goldschmidt.

As indicated in my answers to several of the earlier questions, I feel strongly that the best means of insuring an adequate program of Government-sponsored research on the aged is the establishment of a National Institute of Gerontology. The problems of the aged encompass medical-biological, psychological, social, economic, and demographic aspects. These do not always operate independently but, in fact, are frequently closely interrelated. To subdivide research on the aged so that it fits into one or another of the existing Institutes of the National Institutes of Health may result in narrowing a specific research problem to the extent that it is artificially divorced from the whole of which it is a part. This frequently results in the inability to obtain an integrated and meaningful evaluation of the particular problem under study.

The concentration of all research on the aged in a single Institute should eliminate these dangers. Furthermore, through its control of all grants on gerontological research, such an Institute would be in a better position to assure a

balanced program of research among the medical-biological, social, psychological, economic, and demographic aspects of the aging process.-Sidney Goldstein.

I am not certain whether a National Institute of Gerontology is needed. I should like to see a special Office on Aging established within the U.S. Department of Health, Education, and Welfare which would have as one of its functions the stimulation of research on all aspects of aging. Such an Office could work with the various Government agencies that have any concern with the aging problem to stimulate research in areas that are currently being neglected or that need greater emphasis. The actual research grants might be awarded in some cases through the National Institutes of Health and in other cases through the Social Security Administration, the Bureau of Employment Security, or other appropriate agencies.-Margaret S. Gordon.

The problem posed by item 10 of your letter regarding the organizational approach within the Institutes of Health is, as you recognize, very complex. I know of no solution that will avoid all of the "entangling problems" that are certain to arise, but tend to favor the view that there should be a National Institute of Gerontology within the National Institutes of Health, rather small in size, to serve primarily as a coordinating agency for the aging sections of each of the existing Institutes. This coordinating agency should maintain a constant review of the work being done on questions relating to aging within the Institutes, and, where necessary, bring together the members of different Institutes to work out a coordinated program under the auspices of the Institute of Gerontology.Alexander Grendon.

Second, I would like to express my strong feeling that there should be established a National Institute of Gerontology as one of the complex of Institutes now gathered at Bethesda in the National Institutes of Health. This National Institute of Gerontology I envision as having the status and independence of, for example, the National Cancer Institute, the National Heart Institute, and the National Institute of Mental Health. At the same time, it might be convenient if the other Institutes established sections on aging; however, in my view this is a secondary matter. The sine qua non for an effective program dealing with the problems of the aged is, I believe, the setting up of a National Institute of Gerontology on a par with the other components of the National Institutes of Health. During the past 15 years, gerontology has emerged as a recognized specialty with its own journals and professional organizations; an idea of this expansion may be gained from the fact that more has been published on the subject of aging during the past 10 years than during all previous medical history (cf., vol. 1 and supplement 1, 1949-53, of Nathan W. Shock's "Bibliography of Geriatrics and Gerontology"). At the same time, as already mentioned, the aging of the population has created an intense social and political issue. It would seem, therefore, both appropriate and politic for the Federal Government at this time to organize a National Institute of Gerontology.-Gerald J. Gruman.

I should like to address myself to your question No. 10 ("Should there be a National Institute of Gerontology?") since it would appear to be pivotal_in answering the others. My answer is "Yes"; there should be established a National Institute of Gerontology in the same format as the existing Institutes of Health. But whereas the latter are "disease oriented," the Institute of Gerontology should be organized on a broad professional spectrum and dedicated to the development and conservation of adult human resources. A happy, productive, and healthy citizenry may well constitute the first line of defense of the American way of life in the years ahead.

The economic, political, industrial, sociological, psychological, and humanistic aspects of the problem of aging in this country and in other countries are of sufficient importance to justify U.S. leadership in the area of gerontology. To insure broad gage perspective at the top, the Director of an Institute of Gerontology might well be a distinguished social scientist. He should be encouraged to organize on a broad interdisciplinary basis with strong representation from the basic biological and medical sciences along with the relevant social sciences.Ward C. Halstead.

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